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Nutritional support of children with neoplastic diseases
Insights
Pediatric cancer patients at risk for protein-energy malnutrition (PEM) require tailored nutritional support. Early identification and intervention with enteral nutrition (EN) or parenteral nutrition (PN) improve treatment tolerance and well-being.
Area of Science:
- Pediatric Oncology
- Clinical Nutrition
- Cancer Treatment Complications
Background:
- Protein-energy malnutrition (PEM) is a significant concern in pediatric cancer patients.
- Multiple factors contribute to PEM, including tumor characteristics, cancer treatments, and delayed recognition.
Purpose of the Study:
- To outline strategies for monitoring and supporting pediatric cancer patients at risk for PEM.
- To emphasize the importance of timely and appropriate nutritional interventions.
Main Methods:
- Identification of children at risk for PEM.
- Implementation of comprehensive enteral nutrition (EN) programs.
- Use of parenteral nutrition (PN) or EN in specific treatment phases (radiotherapy, surgery, relapse).
Main Results:
- Nutritional support aims to prevent or correct adverse effects of PEM.
- Interventions can improve therapy tolerance, energy levels, and overall well-being.
- Successful nutritional therapy is defined by achieving established goals.
Conclusions:
- Proactive nutritional assessment and support are crucial for pediatric cancer patients.
- Personalized nutritional strategies, including EN and PN, enhance treatment outcomes.
- Effective nutritional management contributes to improved quality of life during cancer therapy.
Abstract:
There are numerous factors promoting the development of PEM in the child with cancer. Some of these factors are related to the tumor, many to the treatment itself, and some to failure of recognition of PEM. Not all children with cancer are at great risk for the development of PEM. These patients must be monitored and supported with comprehensive enteral programs. Children who have developed or are at risk for PEM must be identified and supported with CPN or PPN plus CEN during early intensive periods of treatment and during the later phases of abdominal radiotherapy, operative resection of tumor, or relapse. The decision to institute CPN must be based not only on the child's current nutritional status but also on the nature of the therapy he or she is soon to receive and the likelihood that he or she will be able to maintain an adequate intake during that therapy. Realistic goals must be set for nutritional support. The value of nutritional intervention lies in its ability to correct or prevent the development of adverse effects related to PEM. This support is hoped to contribute to improved tolerance of therapy, increased energy to complete normal day-to-day activities, and an improved sense of well-being for the child. If these goals have been accomplished, then the nutritional therapy has been successful.